Quantitative 3-Dimensional Chest CT Vascular Reconstruction Before and After Anticoagulation for Pulmonary Embolism

Background Acquiring proficiency for the repair of a cerebrospinal fluid (CSF) leak is challenging in great part due to its relative rarity, which offers a finite number of training opportunities. Objective The purpose of this study was to evaluates the use of a 3-dimensional (3D) printed, anatomically accurate model to simulate CSF leak closure. Methods Volunteer participants completed two simulation sessions. Questionnaires to assess their professional qualifications and a standardized 5-point Likert scale to estimate the level of confidence, were completed before and after each session. Participants were also queried on the overall educational utility of the simulation. Results Thirteen otolaryngologists and 11 neurosurgeons, met the inclusion criteria. A successful repair of the CSF leak was achieved by 20/24 (83.33%), and 24/24 (100%) during the first and second simulation sessions respectively (average time 04:04 ± 1.39 and 02:10 ± 01:11). Time-to-close-the-CSF-leak during the second session was significantly shorter than the first (p < 0.001). Confidence scores increased across the training sessions (3.3 ± 1.0, before the simulation, 3.7 ± 0.6 after the first simulation, and 4.2 ± 0.4 after the second simulation; p < 0.001). All participants reported an increase in confidence and believed that the model represented a valuable training tool. Conclusions Despite significant differences with varying clinical scenarios, 3D printed models for cerebrospinal leak repair offer a feasible simulation for the training of residents and novice surgeons outside the constrictions of a clinical environment.

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Therapeutic effect of cycloserine combined with anti-tuberculosis drugs in the treatment of multidrug-resistant tuberculosis

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v20i2.28 ◽

2022 ◽

Vol 20 (2) ◽

pp. 419-424

Author(s):

Yang Zhao ◽

Mabin Si ◽

Zhihui Li ◽

Xiulei Yu

Keyword(s):

Ct Scan ◽

Multidrug Resistant ◽

Chest Ct ◽

Case Detection Rate ◽

X Ray ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Before And After ◽

Mdr Tb ◽

Chest X Ray

Purpose: The present study analyzes the comprehensive therapeutic effect of cycloserine, in combination with anti-tuberculosis drugs using chest X-ray and chest CT (computed tomography) scan techniques. Methods: A total of 90 patients, diagnosed with multidrug resistant tuberculosis (MDR TB) were subjected to chest x-ray and CT scan before and after treatment in the two groups. Different views such as sagittal, coronal, lung window and multiplanar imaging of mediastinal window were taken. Some parameters such as case detection rate (CDR) in chest X-ray and CT scan and comprehensive curative effect were observed in two groups. Further, the changes in chest CT signs in addition to absorption of focus, cavity closure and changes in CT extra pulmonary signs were also observed. Results: The clinical profile of the patients and the course of disease were statistically insignificant (p > 0.05). Total effectiveness rate and case detection rate (CDR) values exhibited a significant difference between the groups (p < 0.05). Lung consolidation, nodules and cavities significantly improved in both groups before and after the treatment (p < 0.05). Both groups showed significant improvements in extrapulmonary signs in CT scan (p < 0.05) after the treatment. Conclusion: Based on the study outcomes, the CT scan method has good potentials for diagnosing and treating MDR TB at the early stages. Further, it can clarify the signs and outcomes of the disease at early stages, thus providing the medical fraternity a great opportunity to cure the disease.

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Study on the Incidence of Pulmonary Embolism before and after Hip and Knee Replacement Arthroplasties

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.1994.29.3.816 ◽

1994 ◽

Vol 29 (3) ◽

pp. 816 ◽

Cited By ~ 2

Author(s):

Soo Ho Lee ◽

Key Yong Kim ◽

Woo Shin Cho ◽

Dae Hyuk Moon ◽

Yong Sun Cho ◽

...

Keyword(s):

Pulmonary Embolism ◽

Knee Replacement ◽

Before And After

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Myocardial infarction, ischaemic stroke and pulmonary embolism before and after breast cancer hospitalisation

Thrombosis and Haemostasis ◽

10.1160/th10-12-0778 ◽

2011 ◽

Vol 106 (07) ◽

pp. 149-155 ◽

Cited By ~ 3

Author(s):

Sumitra Shantakumar ◽

Pieter W. Kamphuisen ◽

Fernie J. A. Penning-van Beest ◽

Ron M. C. Herings ◽

Myrthe P. P. van Herk-Sukel

Keyword(s):

Breast Cancer ◽

Myocardial Infarction ◽

Pulmonary Embolism ◽

Ischaemic Stroke ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Increased Risk ◽

Before And After ◽

Receive Treatment ◽

Free Women

SummaryWe studied the occurrence of myocardial infarction (MI), ischaemic stroke (IS) and pulmonary embolism (PE) before and after breast cancer hospitalisation compared with cancer-free controls. For this, women with a first breast cancer hospitalisation during 2000–2007 were selected from the PHARMO Record Linkage System, including drug use and hospitalisations of three million inhabitants in the Netherlands, and matched 1:10 by age to cancer-free women. The occurrence of MI, IS and PE were assessed in the 12 months before and after breast cancer hospitalisation. The study included 11,473 breast cancer patients, with a mean (± SD) age of 59 (± 14) years. Breast cancer patients were two to three times as likely as their cancer-free controls to have had a hospitalisation for PE, MI or IS in the 12 months before diagnosis, though prevalence was <1% in all groups. Breast cancer patients experienced an extreme high risk of PE in the first six months after diag- nosis (hazard ratio [HR] 23.5, 95% confidence interval [CI] 11.1–49.7 compared to controls), which declined gradually to a four times increased risk (HR 3.6, 95%CI 2.4–5.5) more than 12 months after breast cancer hospitalisation. However, incidence was low: less than five events per 1,000 person years during all time periods. For MI and IS we did not observe significant increased HRs after breast cancer hospitalisation compared to controls. Breast cancer patients seem to have a higher risk profile to develop MI and IS, and receive treatment that increases the risk of PE compared to cancer-free controls, although the frequency of hospitalisations was low.

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Evaluation of Heparin Prophylaxis Protocol on Deep Venous Thrombosis and Pulmonary Embolism in Traumatic Brain Injury

The American Surgeon ◽

10.1177/000313481307901019 ◽

2013 ◽

Vol 79 (10) ◽

pp. 1050-1053

Author(s):

Mayin Lin ◽

Joseph Vivian Davis ◽

David T. Wong

Keyword(s):

Traumatic Brain Injury ◽

Pulmonary Embolism ◽

Brain Injury ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Clear Trend ◽

Accepted Standard ◽

Before And After ◽

Head Computed Tomography ◽

Heparin Prophylaxis

There is currently no accepted standard for deep venous thrombosis (DVT) and pulmonary embolism (PE) prophylaxis in patients with traumatic brain injury (TBI). The objective of our study was to evaluate the effects of implementing a subcutaneous heparin prophylaxis protocol for patients with TBI that began in our hospital as of June 2009. In our retrospective cohort study, we examined 3812 TBI records between January 2007 and December 2011. A significant reduction in the risk of DVT/PE development was not demonstrated by comparing DVT and PE incidences before and after protocol implementation. A clear trend between heparin use and DVT occurrence could not be determined from a review of TBI records after June 2009. The use of heparin after initiation of our protocol among operative TBI cases without intracranial hemorrhage (ICH) based on admission head computed tomography was 58 per cent. ICH complication from heparin prophylaxis was 10.6 per cent for patients with TBI with ICH on admission (five of 47 cases) compared with 0.7 per cent for those without ICH on admission (four of 535 cases).

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